<?php
/**
 * Magento
 *
 * NOTICE OF LICENSE
 *
 * This source file is subject to the Academic Free License (AFL 3.0)
 * that is bundled with this package in the file LICENSE_AFL.txt.
 * It is also available through the world-wide-web at this URL:
 * http://opensource.org/licenses/afl-3.0.php
 * If you did not receive a copy of the license and are unable to
 * obtain it through the world-wide-web, please send an email
 * to license@magentocommerce.com so we can send you a copy immediately.
 *
 * DISCLAIMER
 *
 * Do not edit or add to this file if you wish to upgrade Magento to newer
 * versions in the future. If you wish to customize Magento for your
 * needs please refer to http://www.magentocommerce.com for more information.
 *
 * @category   design_default
 * @package    Mage
 * @copyright  Copyright (c) 2008 Irubin Consulting Inc. DBA Varien (http://www.varien.com)
 * @license    http://opensource.org/licenses/afl-3.0.php  Academic Free License (AFL 3.0)
 */
?>
<h2>Take The Test</h2>
<div class="contactform">
        <div class="top">
        	<div id="messages_product_view"><?php echo $this->getMessagesBlock()->getGroupedHtml() ?></div>
        </div>
        <form action="<?php echo $this->getFormAction(); ?>" id="contactForm" method="post" enctype="multipart/form-data" style="margin:0" >
        <div class="middle">
          <p>Please answer as many questions as possible, we will study your results and send you our findings by email.</p>
          <table width="100%" border="0" cellspacing="0" cellpadding="4" class="taketesttable">
          	<tr>
              <td>&nbsp;</td>
              <td width="40">Yes</td>
              <td width="40">No</td>
            </tr>
            <tr>
              <td>1. Are your customers pressurising you to improve your performance ?</td>
              <td><input type="radio" name="a1" value="Yes"/></td>
              <td><input type="radio" name="a1" value="No"/></td>
            </tr>
            <tr>
              <td>2. Do you see your competitors as being better organised than yourself ?</td>
              <td><input type="radio" name="a2" value="Yes"/></td>
              <td><input type="radio" name="a2" value="No"/></td>
            </tr>
            <tr>
              <td>3. Are you struggling to keep abreast of developments in your market sector ?</td>
              <td><input type="radio" name="a3" value="Yes"/></td>
              <td><input type="radio" name="a3" value="No"/></td>
            </tr>
            <tr>
              <td>4. Are you concerned that your business is not as well prepared for the unexpected as it could be ?</td>
              <td><input type="radio" name="a4" value="Yes"/></td>
              <td><input type="radio" name="a4" value="No"/></td>
            </tr>
            <tr>
              <td>5. Is your business disadvantaged due to a lack of technical or managerial expertise ?</td>
              <td><input type="radio" name="a5" value="Yes"/></td>
              <td><input type="radio" name="a5" value="No"/></td>
            </tr>
            <tr>
              <td>6. Are your reject or wastage figures hitting your bottom line ?</td>
              <td><input type="radio" name="a6" value="Yes"/></td>
              <td><input type="radio" name="a6" value="No"/></td>
            </tr>
            <tr>
              <td>7. Do you aspire to move your company up the league table ?</td>
              <td><input type="radio" name="a7" value="Yes"/></td>
              <td><input type="radio" name="a7" value="No"/></td>
            </tr>
            <tr>
              <td>8. Do any aspects of your operation seem to be out of control ?</td>
              <td><input type="radio" name="a8" value="Yes"/></td>
              <td><input type="radio" name="a8" value="No"/></td>
            </tr>
            <tr>
              <td>9. Are any key activities reliant on just one individual ?</td>
              <td><input type="radio" name="a9" value="Yes"/></td>
              <td><input type="radio" name="a9" value="No"/></td>
            </tr>
            <tr>
              <td>10. Are you simply “going through the motions” in the way you maintain your management systems ?</td>
              <td><input type="radio" name="a10" value="Yes"/></td>
              <td><input type="radio" name="a10" value="No"/></td>
            </tr>
            <tr>
              <td>11. Are your management systems fragmented ?</td>
              <td><input type="radio" name="a11" value="Yes"/></td>
              <td><input type="radio" name="a11" value="No"/></td>
            </tr>
            <tr>
              <td height="10">&nbsp;</td>
              <td></td>
              <td></td>
            </tr>
          </table>
          <table width="560" border="0" cellspacing="0" cellpadding="4" class="contacttable">  
            <tr>
              <th style="width:180px">Full Name</th>
              <td><input type="text" name="fname" class="required-entry txtinput"  style="width:330px"/> <span class="required">*</span>                  </td>
            </tr>
            <tr>
              <th style="width:180px">Email Address</th>
              <td><input type="text" name="email" class="required-entry validate-email txtinput"  style="width:330px"/> <span class="required">*</span></td>
            </tr>
            <tr>
              <th style="width:180px">Please provide any further details that will further assist us to access your needs.</th>
              <td>
                <textarea name="tellus" class="txtinput" style="width:330px; height:100px"></textarea>  <span class="required">*</span>                 </td>
            </tr>

<tr>
              <th style="width:180px">&nbsp;</th>
              <td><input name="submit" type="image" src="<?php echo $this->getSkinUrl()?>images/submitbtn.jpg" style="background:#000000;color:#ffffff;" /><br/><span class="lightgreyfont">We aim to get back to you within 24 hours of receiving this form</span></td>
            </tr>
          </table>
        </div>
        </form>
        <script type="text/javascript">
		    var contactForm = new VarienForm('contactForm', true);
		</script>
        <div class="bottom"></div>
      </div>